Endometrial cryoablation, a minimally invasive procedure for abnormal uterine bleeding.
OBJECTIVE
To evaluate the effectiveness of endometrial cyroablation for abnormal uterine bleeding.


METHODS
Prospective study with 22 months follow-up (Canadian Task Force classification II-2).


METHODS
University Medical Center.


METHODS
Fifteen consecutive patients treated for metrorrhagia or menorrhagia refractory to medical or surgical therapy, and who were either not operative candidates or did not desire hysterectomy.


METHODS
Cyroablation of the endometrium.


RESULTS
Fifteen patients underwent 16 procedures for dysfunctional uterine bleeding. Uterine sounding depth was 6 to 15 cm. One patient had spinal anesthesia, seven had general anesthesia, and seven had intravenous conscious sedation with a cervical block. Eight patients underwent cryosurgery while fully anticoagulated. Posttreatment endometrial biopsies were performed on three patients and showed only granulation tissue. Life table calculations give amenorrhea rates of 75.5% at 6 months and 50.3% at 22 months. One woman underwent a repeat procedure, resulting in hypomenorrhea at 7-month follow-up.


CONCLUSIONS
This pilot study suggests that endometrial cryoablation may be performed simply and effectively. Future studies should be designed to optimize the technical aspects of the procedure, determine its relative efficacy, and investigate the indications.
Rutherford
T J
TJ
Department of Obstetrics and Gynecology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA.
Zreik
T G
TG
Troiano
R N
RN
Palter
S F
SF
Olive
D L
DL
D003452:Cryosurgery / Q000379:methods*; D004717:Endometrium / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010865:Pilot Projects; D014592:Uterine Hemorrhage / Q000601:surgery*